Colonoscopy Test in Delhi, India

A colonoscopy is a medical procedure that enables doctors to examine the inside of an individual's large intestine (colon) and rectum. The gastroenterologist inserts, through the patient's rectum, a long, thin, flexible tube known as a colonoscope, which is equipped with a light and camera on one end, systematically navigating up the colon and capturing images along the way. This diagnostic procedure is crucial for assessing colon health and detecting any abnormalities or conditions that may require medical attention.

There are two primary types of colonoscopies. It is essential for individuals to consult with their doctors to determine the most appropriate type for their situation and to comprehend the associated benefits before undergoing the procedure.

Screening Colonoscopy

A screening colonoscopy is a preventive examination designed to assess the health of the colon. An individual may require a screening colonoscopy if they exhibit no symptoms of colorectal cancer, have no personal history of colon cancer or polyps, and lack a first-degree relative with a history of colon cancer or polyps.

Diagnostic Colonoscopy

A diagnostic colonoscopy may be recommended if an individual shows possible symptoms or has a strong family history of colon cancer. This type of colonoscopy is suggested if the patient experiences iron-deficiency anaemia, persistent abdominal pain, blood in stool or bleeding from the rectum, a lasting change in bowel habits, or has a personal or family history of colon cancer or polyps.

A doctor might suggest a colonoscopy test for various reasons:

• Investigating intestinal signs and symptoms: A colonoscopy can aid the doctor in exploring potential causes of abdominal pain, rectal bleeding, chronic diarrhoea, and other intestinal issues in a patient.
• Screening for colon cancer: Individuals aged 45 or older, with an average risk of colon cancer (having no risk factors other than age), may be advised by their doctors to undergo a colonoscopy every 10 years. Depending on additional risk factors, the doctor might recommend more frequent screening. Colonoscopy is among the options available for colon cancer screening, and patients are encouraged to discuss the best approach with their healthcare providers.
• Searching for more polyps: If a patient has a history of polyps, a follow-up colonoscopy may be recommended by the doctor to identify and remove any additional polyps. This proactive measure aims to reduce the risk of colon cancer.
• Treating an issue: In certain cases, a colonoscopy may be performed for therapeutic purposes, such as placing a stent or removing an object in the patient's colon.

While a colonoscopy generally carries minimal risks, occasional complications may arise, including:

• Adverse reaction to the sedative administered during the examination.
• Bleeding from the location where a tissue sample (biopsy) was extracted or where a polyp or other abnormal tissue was removed.
• A perforation, or tear, in the wall of the colon or rectum.

Following a thorough discussion about the potential risks associated with the colonoscopy, your doctor will request your consent by having you sign a consent form before proceeding with the procedure.

Before undergoing a colonoscopy, individuals are required to ensure their colon is thoroughly cleansed. Any residue in the colon can hinder a clear view of the colon and rectum during the examination.

To achieve a clean colon, the colonologist may instruct the individual to:

• Adhere to a special diet the day before the exam, typically avoiding solid food. Clear liquids like plain water, tea, coffee without milk or cream, broth, and carbonated beverages are usually permitted. Red liquids, which may be mistaken for blood during the colonoscopy, should be avoided. Eating or drinking anything may be restricted after midnight on the night before the exam.
• Take a laxative, usually prescribed in either pill or liquid form. Typically, the doctor recommends taking the laxative the night before the colonoscopy, and in some cases, both the night before and the morning of the procedure.
• Adjust medications, especially for individuals with diabetes, high blood pressure, or heart problems, or those taking medications or supplements containing iron. Individuals should inform their doctors about their medications at least a week before the colonoscopy. If taking aspirin or other blood-thinning medications like warfarin (Coumadin, Jantoven),

newer anticoagulants such as dabigatran (Pradaxa) or rivaroxaban (Xarelto), or platelet-affecting heart medications like clopidogrel (Plavix), dosage adjustments or temporary cessation may be necessary.

How to Prepare for a Colonoscopy if You’re Pregnant?

In pregnancy, a colonoscopy test is usually advised only when essential but is generally considered safe for both the expectant parent and the baby. If the procedure is for routine screening purposes, the colonoscopy doctor may recommend postponing it until after the individual has given birth.

Given the significance of nutrition during pregnancy, individuals should consult with their doctors regarding the bowel preparation process and inquire about the types of laxatives, if any, that are deemed necessary and safe to use beforehand.

During the Colonoscopy Procedure

During a colonoscopy, individuals wear a gown, and sedation or anaesthesia is usually recommended. The procedure involves lying on the side, with a colonoscope inserted into the rectum. The scope, equipped with a camera, allows the doctor to view the colon's interior by introducing air or carbon dioxide. Individuals may feel stomach cramping or the urge to have a bowel movement during the procedure. The doctor can also use the scope to take biopsies or remove abnormal tissue. A colonoscopy generally takes about 30 to 60 minutes.

After the Colonoscopy Procedure

Post-exam recovery from the sedative takes about an hour. Arrange for someone to accompany you home, as the effects may last up to a day. Avoid driving, important decisions, or work for the rest of the day. Bloating or gas may occur, relieved by walking. Some blood in the first bowel movement is usually not concerning, but consult the best colonoscopy doctor in Delhi or another location for continued blood, abdominal pain, or fever, which could occur immediately or up to 1 to 2 weeks later.

The gastroenterologist will examine the results of the colonoscopy and subsequently communicate the findings to the individual.

Negative result

A colonoscopy is considered negative when no abnormalities are detected in the colon by the doctor.

The gastroenterologist may suggest a follow-up colonoscopy:

• In 10 years, for those at average risk of colon cancer with no additional risk factors apart from age or if benign small polyps are present.

• In 1 to 7 years, based on factors such as the number, size, and type of polyps removed, history of polyps from previous colonoscopies, certain genetic syndromes, or a family history of colon cancer.
• If an incomplete examination due to residual stool in the colon occurs, the doctor might recommend a repeat colonoscopy. The timing will depend on the amount of stool and the extent of the colon that was visible. The doctor may advise a different bowel preparation to ensure complete emptying before the subsequent colonoscopy.

Positive Result

A colonoscopy is considered positive if the doctor identifies any polyps or abnormal tissue.

While the majority of polyps are noncancerous, some may be precancerous. Polyps removed during the procedure undergo laboratory analysis to determine their cancerous, precancerous, or noncancerous nature.

Based on the size and quantity of polyps, a more stringent surveillance schedule may be recommended in the future to monitor for additional polyps.

If an individual has one or two polyps smaller than 0.4 inches (1 centimetre) in diameter, a repeat colonoscopy may be advised in 7 to 10 years, considering other risk factors for colon cancer.

A doctor may recommend an earlier follow-up colonoscopy if the individual has:

• More than two polyps.
• A large polyp exceeding 0.4 inches (1 centimetre).
• Polyps along with residual stool hinder a complete examination of the colon.
• Polyps with specific cell characteristics indicate a heightened risk of future cancer.
• Cancerous polyps.

In cases where a polyp or abnormal tissue couldn't be removed during the colonoscopy, the doctor may suggest a repeat examination with a gastroenterologist specialising in large polyp removal or surgery.

Q1. Is a Colonoscopy a painful procedure?

Patients are given sedation or anaesthesia to minimise discomfort, so the procedure itself is not usually painful.

Q2. What is a Colonoscopy done for?

A colonoscopy is performed to screen for and detect conditions such as colorectal cancer, polyps, inflammatory bowel disease, and other abnormalities in the colon and rectum.

Q3. What does a Colonoscopy check?

A colonoscopy checks the inside of the colon and rectum for abnormalities, including polyps, tumours, inflammation, and signs of colorectal diseases.

Q4. Is a Colonoscopy only for cancer?

No, a colonoscopy is not only for cancer. It is a versatile procedure that can also detect and address other issues such as polyps and inflammatory bowel diseases.

Q5. How do I prepare for my Colonoscopy?

Preparation for a colonoscopy typically involves dietary restrictions and taking a bowel-cleansing solution to ensure the colon is clear for examination.

Q6. How long does it take to recover from a Colonoscopy?

Recovery time varies, but most people can resume normal activities within the day. Some may experience mild bloating or cramping that usually subsides quickly.

Q7. What is Sigmoidoscopy?

A sigmoidoscopy is a medical procedure that involves examining the sigmoid colon, which is the lower part of the large intestine or colon. It is a type of endoscopic examination that allows healthcare professionals to visualise the interior lining of the sigmoid colon using a flexible, lighted tube called a sigmoidoscope.

Q8. What is the cost of a Colonoscopy?

The cost of a colonoscopy depends on several factors, including the location, healthcare provider, insurance coverage, and additional services required. For more information, it's recommended to consult with Max Healthcare for personalised treatment.

Reviewed by Dr. Vikas Singla, Senior Director & Head – Gastroenterology (Pancreatic-Biliary, Luminal Gastroenterology & Endoscopy Division), Hepatology & Endoscopy on 29 Mar 2024.